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首页> 外文期刊>Clinical Medicine: Pediatrics >Hydronephrosis in Infants and Children: Natural History and Risk Factors for Persistence in Children Followed by a Medical Service
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Hydronephrosis in Infants and Children: Natural History and Risk Factors for Persistence in Children Followed by a Medical Service

机译：婴儿和儿童的肾积水：自然病史和持续存在儿童的危险因素以及随后的医疗服务

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Background: Infants with neonatal hydronephrosis and a normal voiding cystourethrogram (VCUG) are presumed to have ureteropelvic junction obstruction (UPJO). There is little current information about the natural history of children with hydronephrosis or clinical factors that predict resolution of the radiological abnormality.Objective: To determine the time course until spontaneous resolution of neonatal hydronephrosis and define risk factors for persistence of the abnormality.Methods: This retrospective single center review examined infants and children < 5 years of age with hydronephrosis who were followed for at least 12 months.Results: 136 children were identified (96 male:40 female). The mean age at diagnosis of hydronephrosis was 3.3 ± 9.7 months and 76% of the patients were diagnosed at birth. The hydronephrosis was unilateral in 98 (72%) of cases, and hydronephrosis was at least moderate in severity in 22% of affected kidneys. At last follow-up at 30 ± 10 months, the abnormality had resolved in 77 out of 115 (67%) available patients, 30 (26%) had been referred to urology, and 12 (10%) had persistent hydronephrosis. Severity of hydronephrosis was the only clinical feature that predicted persistence of the abnormality (P < 0.001). There was an association between detection at birth and lack of resolution of hydronephrosis.Conclusions: Children with hydronephrosis and presumed UPJO and normal kidney parenchyma can be followed for at least 2 years to allow for spontaneous resolution before referral to urology. Serial sonography can be performed at 6 month intervals in uncomplicated cases. More severe hydronephrosis and presence of the lesion at birth may predict infants and children requiring closer observation and referral for possible surgical correction of the hydronephrosis.
机译：背景：推测患有新生儿肾积水和正常排尿膀胱尿道造影（VCUG）的婴儿患有输尿管盆腔连接梗阻（UPJO）。目前尚无关于儿童肾积水的自然病史或可预测放射学异常消退的临床因素的信息。目的：确定直到自发解决新生儿肾积水的时间过程并确定持续存在异常的危险因素。回顾性单中心回顾检查了随访至少12个月的5岁以下肾积水的婴儿和儿童。结果：确定了136名儿童（96名男性：40名女性）。诊断为肾积水的平均年龄为3.3±9.7个月，其中76％的患者在出生时被诊断出。肾盂积水是单侧的，占98％（72％），肾积水的严重程度至少为中度，占22％。在30±10个月的最后一次随访中，在115名（67％）的可用患者中，有77名异常得到解决，转诊至泌尿科的患者为30名（26％），持续性肾积水（12％） 。肾积水的严重程度是唯一可预测异常持续的临床特征（P <0.001）。结论：患有肾积水，推测为UPJO且肾实质正常的儿童至少可以随访2年，以便在转诊至泌尿科前能自发消退。在简单的情况下，可以连续6个月进行一次超声检查。更严重的肾积水和出生时病变的存在可能预示婴儿和儿童需要仔细观察并转诊以进行可能的手术治疗。

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